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Want to Learn More About Your Body’s System of Communication?


Announcing a New Series:

How Your Body Talks:

Estrogen and Progesterone

Stan Gardner, M.D., CNS

Women are different than men (believe it or not!). Some of that difference is related to different levels of messengers called hormones. Two of the hormones–estrogen and progesterone–communicate different things to the same organ. To make matters more complicated, their levels change, depending on the time of month or stage of life.

The Reproductive Years (About age 11 to 45 to 50)

During the reproductive years, most women have regular periods. Part of the purpose of menstruation is to prepare the uterus and body for pregnancy. Of the two hormones I mentioned in the previous paragraph, estrogen levels only change a little during the month. Your body’s hormones are always talking to various tissues. Progesterone levels are quite low from the start of the period until the egg is released from the ovary (ovulation). The scar tissue (corpus luteum) generated where the egg leaves the ovary produces high levels of progesterone until a day or two before the next period starts.

In the uterus, estrogen tells the inside of the uterus (the lining) to produce more cells. When progesterone is produced, it tells the newly produced cells to develop or mature to get ready for a fertilized egg. The fertilized egg loves the newly developed cells, burrows in and starts to divide and divide, becoming a new human being 9 months later.

If the egg is not fertilized, the corpus luteum stops producing progesterone. It tells the uterine cells to remove themselves from the uterus (through the menstrual cycle) and starts the whole process over again.

Estrogen and progesterone talk to nine other organs, and for the most part they confuse the organs by giving them opposing directions.

In the ovary, estrogen stimulates the maturation of the egg. Estrogen tells the egg to move toward the outside of the ovary as it matures. Meanwhile, progesterone suppresses further egg release. If these two hormones were not giving conflicting information, twins and triplets would be much more common.

Balance and Counterbalance

Here are some other fascinating ways that estrogen and progesterone balance and counterbalance in the body:

  • In the breasts, estrogen stimulates tissue growth, occasionally so much that it causes discomfort. Progesterone provides protection from cancer. Because of high progesterone levels during pregnancy, women with multiple pregnancies have a reduced rate of breast cancer.
  • In the bones, estrogen slows bone loss. When estrogen levels drop at menopause, bone loss (osteoporosis) accelerates as the FSH level (follicular stimulating hormone, another hormone messenger that talks to the ovary) rises. Progesterone stimulates new bone growth.
  • In the thyroid, estrogen interferes with the thyroid hormones, while progesterone talks to the thyroid gland and improves its function.
  • In the brain, estrogen stimulates function and improves mental sharpness. Progesterone helps to calm the brain and acts almost like an anti-depressant.
  • Estrogen increases deposition of fat, especially on the hips and thighs. (Testosterone tends to put fat in the abdomen.) Progesterone tells the fat to break down.
  • Estrogen tells the cells to make more progesterone receptors, while progesterone up-regulates estrogen receptors.
  • Estrogen increases retention of water, including helping to hydrate the skin. Progesterone acts as a natural diuretic.
  • Estrogen decreases libido, while progesterone increases it.

Estrogen speaks exclusively to two organs, without counter-talk from progesterone:

First, it talks to support the lining in the blood vessels.

Second, estrogen increases collagen production. Collagen is the connective tissue in the body. Faster healing and softer, more elastic skin take place when estrogen speaks to the connective tissue.

What happens when Estrogen levels are too high, compared to Progesterone levels?

When estrogen talks too loudly, and progesterone influence is minimized, it is called estrogen dominance. This condition causes some classic symptoms:

  • Water retention
  • Breast tenderness, lumps, cysts
  • Moodiness, emotionally labile, anxiety, depression
  • Decreased libido
  • Heavy bleeding, clotting, and/or cramping
  • Fibroids, endometriosis
  • Polycystic ovarian syndrome

What Happens When Estrogen (and Progesterone) Levels Drop?

When neither estrogen nor progesterone talks to the body, some women have no problems, while others are incapacitated. This time of life is called menopause, and may happen naturally or after surgical removal of the ovaries.

The following difficulties may arise with onset of menopause:

  • Mental fog, forgetfulness
  • Anxious, depressed, mood change
  • Hot flashes, night sweats
  • Dry eyes, skin, vagina
  • Insomnia
  • Fatigue
  • Pain and stiffness
  • Palpitations, (racing heart)
  • Headaches
  • Feeling bloated

Is There Any Help?

Yes, there is help, if it is needed.

First, however, let me state that I am opposed to synthetic, chemically changed forms of estrogen. These forms of treatment include a chemical group(s) that has been added to the chemical structure of estrogen the body makes, so it can be patented and sold as a pharmaceutical.

Unfortunately, that extra chemical has caused unwanted side effects. This causes a number of problems, which come from communicating to the wrong organ in the wrong way:

  • Blood vessel clots, causing heart attack, stroke
  • Endometrial and breast cancer
  • Double the risk of dementia
  • Double the chance of surgery to remove the gall bladder

If there is a reason to treat hormonal issues, my first choice is to choose herbs and natural products that function as phytoestrogens and support, or speak to the ovaries.

Some of these include:

  • Angelica sinensis
  • Blessed thistle
  • Licorice root
  • Wild yam
  • Motherwort herb
  • Black cohosh
  • Cramp bark
  • Dong quai

Although these natural products may not be as strong as bio-identical estrogen and progesterone, they may talk to your organs well enough to solve the problem.

Bone Density

Bone loss around the time of menopause is a reason to be aggressive with reducing the FSH level. In treating patients with bone loss, I typically start with progesterone, to see if stimulating the estrogen receptors is enough to solve the problem. If not, then bio-identical estrogen is usually needed.

If, on the other hand, estrogen is talking too loudly in your body (dominating), then bio-identical progesterone is usually needed. I generally prefer that a local compounding pharmacist formulate the progesterone, rather than a pharmaceutical firm, which tends to use unnecessary fillers. Unfortunately, insurance companies tend to pay for pharmaceuticals, rather than healthier, more natural products.

When neither estrogen nor progesterone is communicating with your body, and you need help (sometimes desperately!), I always start with a natural product. If that is insufficient, the next step is progesterone. Everyone likes progesterone—just look at what it does to the body. If more is still needed, I pay attention to symptoms and response to what has been added, and then add bio-identical estrogen until the symptoms resolve.

To your dynamic health and energy,

Dr. Stan Gardner

If you would like more information about Dr. Gardner and his philosophies, please feel free to explore this site. Dr. Gardner’s office is in Sandy, UT. Phone number 801-302-5397. 

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Menopause and Food

A reader writes:

This is the first time on your web page. My biggest concern is I am 56 yrs old and in the middle of menopause. I use herbs to help with the symptoms but sometimes the hot flashes are so strong and frequent i get depressed. I believe there is a correlation between hot flashes and food.

My response:

Although the specific causes of menopause symptoms are not well elucidated, the general consensus is that it is due to decreasing estrogen levels in the body. When a woman is in childbearing years, estrogen causes growth of the inside layer of the uterus (called the endometrium). Progesterone, produced from the ovary after ovulation takes place, matures this endometrial layer in preparation for a fertilized egg. If no fertilization takes place, this endometrial layer is sloughed off (called a period) and the cycle repeats itself. As the ovary ages, it becomes less and less capable of producing the same levels of estrogen and progesterone, the cycles change and finally after 1 year of no menstrual cycle, a woman is in menopause. During this peri-menopause and post-menopause period some women have menopausal symptoms–hot flashes, night sweats, dryness, brain fog, insomnia, decreased energy. Treatment consists of stimulating estrogen receptors so the symptoms diminish. The over-the-counter herbs have weak estrogenic properties, often called phytoestrogens. They work in some women because there is more stimulation of the estrogen receptors than before, and that small amount is all they need. If that does not work, you may need to see a physician trained in bioidentical hormones. I use progesterone first because it improves the estrogen receptors to be more receptive to whatever stimulus that may be present. If that is inadequate, then I add bioidentical estrogen until the symptoms improve or are eliminated.

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More on Menopause

I started progesterone four months ago to obtain relief from menopausal symptoms, with great results. I was told to expect to have a period, but I haven’t had one. Should I be concerned?

You need two hormones to have a period.

First, the estrogen component thickens the endometrial lining (the inside of the uterus), and it is this material that is sloughed off with each period.  In the second half of the cycle, progesterone is produced by the ovary to mature the endometrial lining in preparation for egg implantation.  The sudden drop in estrogen and progesterone levels seem to be the trigger for the period to start.  Then the cycle starts over again.

If there is no estrogen, there cannot be a period because there is nothing to slough off, whether you are on progesterone or not.  If you are taking your progesterone daily and not cycling it, it is also less likely you will have a period.

Short answer–there is nothing to be concerned about if you are on progesterone and not having a period.

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What is normal Menopause? When is it not normal that I would have to seek medical attention from a doctor who is not traditional but holistic alternative.

Menopause, by definition, is going without a period for 12 months.  The period stops because the hormones that cycle in order to have periods have diminished, and all of this is normal.

Some women have annoying or devastating symptoms associated with these changes, and others have no symptoms.  When the symptoms interfere with the quality of your life, it is time to try some things or see a physician who uses bio-identical hormones.

Conventional medicine continues to use ‘fake’ estrogen and ‘fake’ progesterone to treat these symptoms, even in the face of significant side effects shown in their studies.  Over-the-counter products like Vitex, Dong Quai and Black Cohosh have helped many people, and others have found low-dose progesterone from yam sources helpful.  If these are insufficient to get your life back, it is time to see someone with experience with bio-identical hormones in the alternative/holistic medicine field.

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Menopause Symptoms

My biggest concern is I am 56 yrs old and in the middle of menapause. I use herbs to help with the symptoms but sometimes the hot flashes are so strong and frequent i get depressed. I believe there is a correlation between hot flashes and food.

Menopause symptoms are related to a deficiency of estrogens. Not every woman has hot flashes and night sweats in their menopausal years, but for those who do, it can be most debilitating. The only correlation I am aware of with menopausal symptoms and food is sugar, and processed foods will make the symptoms worse.

Certain herbs have mild estrogenic activity, and are often called phytoestrogens. These include:

  • isoflavones from soy and red clover,
  • Dong Quai and
  • Black cohosh.

Depending on the severity of the symptoms and responsiveness of your body, they may be sufficient. If not, you will probably need prescriptions to take care of the symptoms. Progesterone makes the estrogen receptors in your body more responsive, and this may be enough. If not still, then  bioidentical estrogen will be needed. You’ll need to find a physician or health practitioner familiar with this approach.

I have not been able to get a good restful sleep at night for the last several months. Also I have been having many issues of hot flashs over and over where i am totally soaked through my clothes and my hair is streaming wet. not a good thing to have happen when you work with customers every day like I do.

I will assume that your sleep problems are because of your menopausal symptoms of night sweats and hot flashes. Menopausal symptoms are related to decreased/decreasing estrogen levels in your body. Some things to try:

1. Phytoestrogens, which are weak estrogens, may help enough to reduce or eliminate your symptoms.

2. Progesterone can sensitize your estrogen receptors to make them more sensitive, which may also help.

3. If that does not work, you will need to find someone who will prescribe bio-identical estrogen (I usually use Biest), and that will usually get rid of those symptoms.

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